Barbados and other small island developing states (SIDS) must unite to confront powerful global industries whose products exacerbate chronic diseases and undermine public health, according to Senator Jerome Walcott, Minister of Health. Speaking at the opening of a three-day global conference organized by the Healthy Caribbean Coalition (HCC) and the Pan American Health Organisation (PAHO), Sen. Walcott emphasized the need for governments to balance economic growth with the well-being of their citizens. The conference, titled ‘Addressing the Commercial Determinants of NCDs in the Caribbean SIDS,’ was held at the Courtyard by Marriott. Sen. Walcott highlighted that public health strategies have traditionally focused on individual behavior change but stressed the importance of addressing upstream factors such as policies, markets, and environments that shape health choices. He identified the tobacco, alcohol, ultra-processed food, and fossil fuel industries as major contributors to global mortality rates, noting that these industries are responsible for over one-third of annual global deaths. Their economic and political influence often leads to policy inertia and hesitancy in implementing decisive health measures. Sen. Walcott pointed out the dilemma governments face: industries like tobacco and alcohol contribute significantly to GDP and employment, yet their products drive disease and premature death. While these industries may boost short-term revenue, the long-term consequences include strained health systems, reduced productivity, and hindered economic development. The World Economic Forum estimates that premature deaths from non-communicable diseases (NCDs) in lower and middle-income countries will cost $7 trillion over the next 15 years. Sen. Walcott called for bold action, advocating for fiscal measures such as excise taxes on unhealthy products to reduce consumption and generate revenue for health promotion. He stressed that the primary purpose of such taxes should be health, not profit, and suggested dedicating a portion of the revenue to NCD prevention and control. Additionally, he urged integrating health considerations into all sectors, including trade, agriculture, and economic planning, and called for restrictions on advertising unhealthy products, ensuring access to nutritious foods, and incentivizing the production of healthier alternatives. Sen. Walcott emphasized the importance of collaboration through CARICOM, PAHO, civil society coalitions, and academic institutions to share evidence and resources. He linked these efforts to Barbados’ national development framework, Mission Barbados, specifically Mission 4, which aims to reduce new NCD cases and crime by 50%. In conclusion, Sen. Walcott warned that the commercial determinants of health are among the most powerful drivers of disease today and called for courage, collaboration, and clarity of purpose to address these challenges.